HbA1c levels among primary healthcare patients with type 2 diabetes mellitus in Oman

To investigate whether younger patients with type 2 diabetes mellitus have higher glycated hemoglobin A1c [HbA1c] levels compared to older patients, and to determine the factors associated with higher HbA1c levels. Data from 1,266 patients from all over Oman were used to obtain the mean HbA1c level, odds ratios [OR], and 95% confidence intervals [CI] from multiple logistic regression models with age groups, sex, duration of diabetes, diabetes treatment, body mass index, estimated glomerular filtration rate [eGFR], tobacco use, and healthcare index as predictors of good [HbA1c <7%] vs.poor [>/= 7%] glycemic control. Mean HbA1c levels were 8.9, 8.3, and 7.8 in the age groups 20-39, 40-59 and 60+ years, respectively. After controlling for all other covariates, the OR of good glycemic control increased with age, 40-59 years old [OR=1.7; 95% CI 1.1 to 2.6] and 60+ year [OR=2.5; 95% CI 1.6 to 4.0], female gender [OR=1.5; 95% CI 1.2 to 2.0] and in patients with eGFR >/= 60 mL/min/1.73 m[2] [OR=1.9; 95% CI 1.1 to 3.3]. Longer duration of diabetes [>/= 5years] and treatment with oral agents or insulin were inversely related to good glycemic control. Younger Omani adults exhibit worse glycemic levels compared to older adults posing a formidable challenge to diabetes care teams

Pregnancy outcomes of diabetic women: charting Oman's progress towards the goals of the saint vincent declaration

Oman provides comprehensive care for the detection and management of diabetes during pregnancy with the goal of reducing or eliminating adverse outcomes for mothers and newborns. We assessed the outcome of pregnancies complicated with diabetes as compared to healthy controls. A 1-year retrospective review of registry records was conducted on pregnant women with gestational diabetes mellitus [GDM] and pre-gestational diabetes mellitus [PGDM]. Of the 5394 women registered, 225 had GDM and 56 had PGDM. Fourteen cases of GDM and 2 cases of PGDM were excluded. For each patient recruited, the next healthy control of the same age and parity was selected. Nearly 80% of diabetic women achieved good glycemic control [hemoglobin A1c <7%]. Adjusted for hypertension and body mass index, the risk of macrosomia was three times higher among women with GDM [OR=3.03, 95% CI=1.36-6.75] and up to seven times higher among those with PGDM [OR=7.20, 95% CI=2.30-22.61]. A significantly higher risk of cesarean delivery was observed among women with GDM [OR=2.70, 95% CI=1.17-4.03] and PGDM [OR=4.39, 95% CI=1.68-11.49]. Admission to the special care baby unit was higher among infants born to mothers with PGDM [OR=5.70, 95% CI=2.40-13.51] and GDM [OR=2.85, 95% CI=1.68-4.83]. The findings indicate that many of the unfavorable pregnancy outcomes of diabetes for women and infants have not been brought under control despite the comprehensive care provided. Further studies are recommended to evaluate the system of care provided to pregnant women and to identify gaps in achieving the goals of the St. Vincent Declaration